Provider Demographics
NPI:1376665331
Name:KLEIN, RONALD L (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 N SUMNEYTOWN PIKE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-2533
Mailing Address - Country:US
Mailing Address - Phone:215-699-4478
Mailing Address - Fax:215-699-5570
Practice Address - Street 1:311 N SUMNEYTOWN PIKE
Practice Address - Street 2:SUITE 2B
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-2533
Practice Address - Country:US
Practice Address - Phone:215-699-4478
Practice Address - Fax:215-699-5570
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO21839L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1912918087OtherTYPE 2 PRACTICE NPI #